[Postoperative radio-chemotherapy in locally advanced gastric cancer].
BACKGROUND
Overall 5 years survival for surgically excised gastric cancer is 30%. Adjuvant treatment may improve the surgical results.


OBJECTIVE
To assess treatment results and toxicity in patients with surgically excised gastric cancer, treated with adjuvant radiotherapy and concomitant continuous 5-Fluorouracil (5-FU).


METHODS
Forty one patients aged 32 to 73 years (29 males) with stage II-IVA gastric cancer, subjected to a total or subtotal gastrectomy and D2 nodal dissection between 1997 to 2006, were studied. They received adjuvant radiotherapy to the gastric bed and draining nodes in a total dose of 50.4 Gy in 28 fractions and chemotherapy with continuous infusion 5-FU, 200 mg/m(2)/day. Results were compared to historical controls matched according to demographic parameters and tumor characteristics.


RESULTS
Eighteen patients were in stage II, 10 in stage IIIA, nine in stage IIIB and four in stage IVA. Twelve patients had an NO nodal status, 15 were NI, nine were N2 and five were N3. After a mean follow up of 32 months, 26 patients (63%) were alive. Five year overall survival was 49.6% for surgery plus radiochemotherapy compared to 30.7% for the historical group subjected only to surgery (p =0.002). Radiotherapy was associated with grade 1-2 toxicity and treatment was completed without interruptions in all patients. Chemotherapy was delayed temporarily in 3 patients.


CONCLUSIONS
Adjuvant radio-chemotherapy improved overall survival in gastric cancer, compared to historical controls subjected only to surgical treatment.
Garrido
Marcelo
M
Departamento de Hematología-Oncología, Programa de Cancer, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Bustos
Marisa
M
Orellana
Eric
E
Madrid
Jorge
J
Galindo
Héctor
H
Sánchez
César
C
Pimentel
Fernando
F
Guzmán
Sergio
S
Ibáñez
Luis
L
Butte
Jean Michel
JM
Alvarez
Manuel
M
Besa
Pelayo
P
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011829:Radiation Dosage; D018714:Radiotherapy, Adjuvant; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D015996:Survival Rate
D005472:Fluorouracil